title: Ofatumumab for refractory opsoclonus-myoclonus syndrome following treatment of neuroblastoma.
abstract: Opsoclonus-myoclonus syndrome (OMS) may be associated with ANNA-1 (anti-Hu) autoantibodies. The standard treatment with IVIG, steroids, and anti-CD20 monoclonal antibody may fail, and optimal therapy is unknown. A patient developed OMS with high-titer ANNA-1 following recovery from neuroblastoma. She failed standard therapy and had only transient response to rituximab. Treatment with the humanized anti-CD20 monoclonal antibody ofatumumab combined with methotrexate resulted in transient neurologic improvement and decrease of ANNA-1. This suggests that ofatumumab combined with methotrexate should further be considered OMS patients, particularly in refractory disease.
authors.affiliation: Department of Internal Medicine and Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Tyler G
authors.initials: TG
authors.lastname: Ketterl
authors.forename: Yoav H
authors.initials: YH
authors.lastname: Messinger
authors.forename: Dawn R
authors.initials: DR
authors.lastname: Niess
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gilles
authors.forename: William Keith
authors.initials: WK
authors.lastname: Engel
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Perkins
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D051959:ELAV Proteins / Q000276:immunology; D005260:Female; D006801:Humans; D007223:Infant; D008479:Mediastinal Neoplasms / Q000150:complications*; D008727:Methotrexate / Q000008:administration & dosage; D009447:Neuroblastoma / Q000150:complications*; D053578:Opsoclonus-Myoclonus Syndrome / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001323:Autoantibodies; D001324:Autoantigens; D051959:ELAV Proteins; C527517:ofatumumab; D008727:Methotrexate
keywords: neuroblastoma; ofatumumab; opsoclonus-myoclonus syndrome; rituximab